Citing speech delay concerns, Alex Wood’s son’s Pediatrician referred them to the Arizona Early Intervention Program (AzEIP) when he was about 18 months old. Her son babbled but he wasn’t using as many words as expected for his age, Wood said. Because it was during the COVID-19 pandemic, the assessment happened via video call. The team identified that Wood’s son had delays but he didn’t meet the criteria to qualify for AzEIP speech therapy services.
Wood’s AzEIP team recommended a group called Parents as Teachers – Children with Special Needs, a home visiting program. A developmental specialist brings activities or lessons each week that They work on together, and Wood reinforces these lessons between visits. This grant-funded service is available at no charge to her family.
Wood also started her son in private speech therapy covered by his medical insurance. He turns 3 in August and Wood plans to have him assessed for the Tucson school district’s developmental preschool program.
AzEIP provides assessments and services to children from birth to under age 3. However, only about one in three children referred to AzEIP are ultimately determined eligible, meaning two-thirds of AzEIP referrals are for children who do not qualify for developmental services.
To qualify, children must have a diagnosis of an established condition or a delay of at least two standard deviations – approximately 50 percent below the mean – in at least one of the following developmental areas:
- physical
- cognitive
- language/communication
- social/emotional
- adaptive/self-help skills
If your child doesn’t qualify for AzEIP but you still have concerns about development, other resources are available for your family.
USING MEDICAL INSURANCE
If your child is covered by commercial health insurance, contact your insurance company to confirm the available benefits and requirements. You’ll want to keep your primary care physician in the loop because you might need a referral or prescription for a developmental assessment or therapy services. Your primary care physician (PCP) can also recommend providers in your region.
Commercial or private insurance coverage for services like speech or physical therapy might require parents to pay co-pays for each visit. Or you might need to meet a deductible amount and then pay coinsurance, or a percentage of the cost for each visit. Each insurance company varies, so contact your insurance company for your plan’s specific information. Or if you’ve already chosen a therapist, you can ask about cash pay options, which sometimes provide discounts.
If your portion of fees is cost-prohibitive for your family, grant programs can assist with covering these expenses. For example, the UnitedHealthcare Community Foundation grant can help pay for medical expenses that are not covered, or not fully covered, by a family’s commercial health insurance. Families do not need to be covered by UnitedHealthcare to apply for the grant, but they do need to be covered by a commercial or private health insurance plan.
If your child is covered by an income-based plan through the Arizona Health Care Cost Containment System (AHCCCS), you can contact your child’s primary care physician to obtain referrals for screening, evaluation and treatment. AHCCCS also offers health insurance through KidsCare for eligible children under age 19 who are not eligible for other AHCCCS health insurance, with monthly premiums for those who qualify. When applicable, developmental screening and therapy is covered under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
You might need proof of your child’s AzEIP assessment, along with a referral or prescription from your child’s PCP to request and access developmental services from an AHCCCS network provider. Contact your AHCCCS plan and your child’s primary care physician for information about this process.
Pediatrician Clifford Gross, MD, FAAP sees patients at Mountain Park Health Center in Phoenix and encourages parents to keep up on developmental recommendations. “If a child is referred to AzEIP and doesn’t qualify, this is still a patient that needs closer follow up,” Gross noted.
For example, if a child is referred and doesn’t qualify for AzEIP at 18 months, it might be too long to wait until the child’s next exam, traditionally at age 2, to check back in on developmental concerns.
He encourages parents to keep in contact with their pediatricians and request more frequent visits if needed to address developmental milestones.
COMMUNITY RESOURCES AND PROGRAMS
Community-based services can also help parents monitor their child’s developmental needs. Some options are available at no cost to parents; some have income or geographic requirements. Other options have fees or can go through insurance plans.
Home visiting programs and family resource centers can provide new and expectant parents with information, support and referrals to other community agencies. Trained home visitors or other staff can also help monitor any delays. There are several programs throughout Arizona; search online at Strong Families or First Things First to find one near you.
Strong Families offers home visiting programs to target different needs including developmental delays. As Arizona’s early childhood agency, First Things First supports home visiting programs and other resources across Arizona through grants to community organizations that provide services at no cost for young children and their families.
These programs can provide a “safety net” for children with mild to moderate delays, said Vincent Torres, senior director, children’s health with First Things First. “If the child didn’t reach the threshold to qualify for AzEIP, another organization working with the family can prevent the child from falling through the cracks by connecting the family to other resources.” This might include monitoring development and recommending another referral to AzEIP if the child isn’t meeting milestones by a specific age.
The First Things First website provides substantial information on its Parent Resources page. Ages and Stages milestones sheets can be printed and brought to doctors’ appointments to discuss developmental concerns, and the Find Programs link can help parents locate different resources throughout Arizona. First Things First’s Region Stories page also offers examples of early childhood programs and services organized by geography. Learn more about how parents around the state access different resources.
Southwest Human Development also offers options for concerned parents. Jennifer Harrison, MS, CLE, CIMI with Southwest Human Development’s Smooth Way Home program, recommends that parents start by calling the Birth to 5 Helpline at 877-705-KIDS (5437). This statewide resource can help parents to identify which programs could fit.
“We individualize our recommendations based on the child’s needs,” Harrison said. “We can help fill that ‘watch and see’ gap.” One resource, Smooth Way Home, is available for all children up to 1 year old who spent time in a hospital’s neonatal intensive care unit (NICU).
Southwest Human Development’s Birth to Five Center of Excellence also offers evaluations, assessments and plans, and can offer therapy. This center accepts some commercial insurance plans and AHCCCS plans and can offer cash pay services. For more information, call 602-633-8198 or visit the Birth to Five Center of Excellence online. Early Head Start can begin at 6 weeks of age and provides home- or center-based services until a child turns 3. Early Head Start focuses on physical, cognitive, social and emotional development of infants and toddlers. Some programs are offered through Southwest Human Development and others are provided through other community agencies or the City of Phoenix.
Head Start preschool programs start at age 3. These programs have income requirements and families might need to live within specific school districts. Contact the Arizona Head Start Association for more information.
Another resource, Parents as Teachers is an international organization that promotes early childhood development, learning and health by partnering developmental and educational professionals with parents. Parents as Teachers programs are offered around the state; search for a program near you on their website.
Based in Tucson, Parents as Teachers – Children with Special Needs was created specifically for children who don’t qualify for AzEIP, noted program supervisor Kamanitha Gunawardana. This home visitation program works with children using a specialized curriculum to address mild to moderate developmental delays or behavior challenges during weekly visits. The program also works with children who have chronic medical conditions.
Enrollment usually starts between birth to age 3 and the program will work with families until the child turns 5 or goes to kindergarten. This grant-funded program is free and serves 17 zip codes in the Tucson area. Other Parents as Teachers programs work with families in Cochise and Yuma counties. For more information, email parentsasteachers@blake.easterseals.com. A similar program, Side by Side, serves specific ZIP codes in the south Phoenix area.
NEXT STEPS
Parents can always consider re-referring their children for another AzEIP assessment, especially if their child receives a new diagnosis or other information that might help them qualify. There is no requirement to wait a specific amount of time before re-referring, although doctors might recommend waiting until a specific age, like 18 months or 2 years. However, a doctor’s referral is not required to request an AzEIP assessment.
If a child is close to age 3, families can also contact their neighborhood school district to request an assessment for developmental preschool. Children who meet state eligibility criteria can qualify for these preschool programs starting at age 3 until the child starts kindergarten.
If you have a concern about your child’s development and your child didn’t qualify for AzEIP, contact Raising Special Kids and a family support specialist can help you navigate the different options. Raising Special Kids also has an Early Childhood page on our website with information on developmental milestones and resources for families.
Above all, parents need to trust their instincts. “Parents need to feel that they are not crazy,” Gross said. “They should feel like their pediatrician listens to them, validates and acts on their concerns. If a parent has a concern, it should be taken seriously.”